Provider Data Roadmap

Maintaining accurate healthcare provider data is onerous, prone to error and costly. To address this long-standing industry challenge, CAQH convened the Provider Data Action Alliance, bringing together a diverse cross section of more than 20 healthcare leaders, representing health plans, provider organizations, state and government representatives, regulators and HIEs.

The result was “An Industry Roadmap for Provider Data.” The Roadmap details principles to guide the development of an industry solution, an overall vision for what the provider data ecosystem should look like and a three-phase plan to implement the vision.

Specifically, the roadmap identified five major recommendations:

Declare commitment to the vision: The industry must publicly commit to taking joint action to catalyze momentum and achieve industry alignment.

Form a not-for-profit, multi-stakeholder governance structure: To succeed, this endeavor requires governance by a diverse set of stakeholders capable of defining and shaping the necessary solution details.

Define an initial dataset and establish standards: Participating stakeholders should align on scope by defining the initial dataset on which to focus, as well as the standard against which to measure data quality.

Engage regulators and other essential groups to inform transformation: Educate regulators, accreditors and other stakeholders on the industry commitment so that, over time, any regulations and/or standards can be aligned with the industry solution.

Begin to formally measure and share the impact of industry efforts: Establish measures for value, cost and overall data accuracy so that the results of the industry-led effort can be assessed.

Individuals from more than 100 other healthcare organizations reviewed drafts and provided input on the final Roadmap. As industry awareness grows, CAQH and the Alliance will solicit additional support for the Roadmap and determine the next steps required to achieve consistent, high-quality healthcare provider data for all stakeholders.